Provider Demographics
NPI:1184785560
Name:GUILD, JOHN LEONARD (DC)
Entity type:Individual
Prefix:
First Name:JOHN
Middle Name:LEONARD
Last Name:GUILD
Suffix:
Gender:M
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:117 S EAST ST
Mailing Address - Street 2:
Mailing Address - City:CAMBRIDGE
Mailing Address - State:IL
Mailing Address - Zip Code:61238-1221
Mailing Address - Country:US
Mailing Address - Phone:309-937-5391
Mailing Address - Fax:
Practice Address - Street 1:117 S EAST ST
Practice Address - Street 2:CAMBRIDGE CHIROPRACTIC
Practice Address - City:CAMBRIDGE
Practice Address - State:IL
Practice Address - Zip Code:61238-1221
Practice Address - Country:US
Practice Address - Phone:309-937-5391
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-12-12
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
T37878Medicare UPIN
IL690380Medicare ID - Type Unspecified